Your Emergency Didn’t Just Happen Today

It hits like a ton of bricks. The bad news you knew was coming. Please no, not today.

You wish you could have a do-over–go back to bed, wake up, and try again, like in Groundhog Day.

But you can’t…

Or can you?

Meet My Patients

Patient A

A was a sweet teenager seeking evaluation for breast tenderness. Her physical exam was normal, though in her history she shared that she was having unprotected sex.

She was devastated to learn she was pregnant.

Patient B

B was a stoic lady also seeking evaluation for a breast issue–this time a “cellulitis” that had persisted for nine months despite multiple courses of antibiotics. Her physical exam was markedly abnormal with masses, back tenderness, and leg weakness.

Her family was visiting for the holidays and convinced her to come to the Emergency Department for evaluation. They were, of course, also devastated by the diagnosis of metastatic breast cancer. They sobbed and wailed, “Why did this have to happen at Christmas?!”

Patient C

C requested evaluation for a headache he’d had for many years. He had a normal neurological exam and appeared quite comfortable.

When I asked what was different today that led to his ED visit–why he had come today instead of last week or next week–he stated that he was homeless and it had gotten cold outside, so he wanted someplace warm to eat and sleep.

Patient D

D came because he “didn’t feel good” for the past decade. He came today because a neighbor finally made him, but he was adamant that nothing had changed acutely and he wanted to be left alone.

I had to tell him he had end-stage liver disease with ascites and multi-organ failure, likely with metastatic hepatic cancer as well.

To add insult to injury, he was also suffering from alcohol withdrawal because today was the day he finally decided to quit drinking.

Patient E

E’s family dropped her off and quickly left. She was very pleasant and kind, and she was also convinced that it was 1962. She felt great and made fast friends with all the staff for the three days she spent in our ED.

There was nothing emergently medically wrong with her, so she didn’t meet criteria for admission to the hospital. Nevertheless, she couldn’t go home because we couldn’t locate her family and she was too confused to care for herself. Her family had decided that they couldn’t or wouldn’t take care of her anymore.

Not Today

My heart breaks for all of these patients, and I wish there were more I could do to help. I try my best to be patient, kind, and encouraging while also being honest about their options moving forward.

It’s clear that none of these problems began today. They’re not truly ‘emergencies‘ in that sense, though they are definitely life-changing conditions that merit assistance.

For these patients, there’s no point focusing on the past and what could have been done differently.

For us, though, there’s still time.

We can learn from these unfortunate stories and examine our own lives and habits before it’s too late.

Not All ‘Emergencies’ Can Be Prevented

I’m not saying that every accident can be prevented, nor that we should wrap ourselves in bubble wrap before stepping out the door each morning.

Life happens. It’s beautiful, and sometimes it’s messy.

And sometimes it gives you hints about what will happen next.

An Ounce Of Prevention

While more and more research reveals that annual checkups probably aren’t necessary or helpful, seeing your doctor for specific questions or complaints definitely can be.

Together, we can confidentially discuss different options for birth control and safe sex to develop a plan that works with your values and your lifestyle. Teenagers- this is a private visit that we will not discuss with your parents without your approval.

We can review the pros and cons of various cancer screenings vs evaluation only when you have symptoms. If you have concerns, we can arrange for imaging, lab tests, and biopsies, then explain several treatment plans and help you figure out what’s right for you and your family.

Even if you don’t have urgent medical needs, our social workers can help locate resources for shelters, food banks, job training programs, and mental health clinics.

If you’re ready to confront an addiction, we can arrange for detox or rehabilitation programs for substance and alcohol abuse.

When you find that your loved one needs more help than you are capable of giving, we can navigate the maze of elder and dementia care with you to ensure your loved ones are safe and well-cared for.*

If you have other questions or concerns, try us. We might not have the answers, but we can work to find them together.

Unfortunately, ignoring problems rarely eliminates them. Instead, they fester until they explode. We’re happy to help whenever you need us, but the sooner you come the more we can do.

Please don’t procrastinate for months and then make us give you bad news on Christmas. See your doctor now, then visit us next Christmas to celebrate your remission.

What will you do today to improve your future health and wellbeing? Please share your recommendations for other community resources.

Related

Comments 14

These are sobering stories. How unfortunate that some keep their head in the sand forever and others lift their heads up when it’s too late. You’re right though. Fortunately there’s time for us. I hope this is a warning to anyone avoiding a serious health or life issue. Refusing to think about it or deal with it won’t make it go away. There’s always some type of help available, somewhere, if you look for it.

So many sad tales here – and I’m sure you see that so often. I think people ignore health issues in a similar way that many ignore financial issues. Taking control is … scary? Too much work? Not sure – but I wonder if it could be many of the same folks – and if there would be a way to help them change their behavior for both situations.

I think it’s all of the above and not wanting to take time for themselves or make their family worry about them. Some of it is also denial.

You’re right that it all goes together. I think if you have one area of your life on track, it’s easier to gain control of the others. Or to put it another way, if one area of your life is a mess, the other areas will be too.

Good habits and communication feed off each other and lead to great progress.

Thanks for the nice kick in the pants. I haven’t had a physical in two years and I need to go. I am also started going back to the gym b/c I have gotten a little loose in the cage as Tony Horton likes to say. Thanks for sharing your stories!!!

These are heartbreaking situations, and my heart goes out to all involved – thanks for sharing. My takeaway is that there is almost always help if we’re humble/brave enough to seek it out. Help very often leads to hope, which can provide motivation to improve our current lot in life.

Time to reevaluate and see if I’m ignoring anything that needs attention. Thanks again for sharing this.

Ty, the new year (am I jumping the gun?) is a great time for self-reflection and evaluation. Hopefully people will nip small problems in the bud before they become much more difficult to treat.
Wishing health and happiness to you and your family!

Interesting to see this from a wide angle when it is so focused for each involved. This is a big eye opener and one that all of us can relate to. You’re right, we do tend to not want to put our lives on hold for our health. I’ve heard people complain about things for years but never get them checked out. Like having the problem has become normal in a way. Or, if it is someone we love we encourage them to get it checked out but we don’t do the same for ourselves. It’s silly, really. Well, after reading this I made a dentist appt for the first time in two years. Just a check up but it’s a step in the right direction!!

Yay! I always dread dental appointments too, but they’re not so bad and I always leave feeling great. Like most things in life, when we stop worrying and procrastinating and just do them, we feel so much better.

Hall of Fame

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If you have any medical questions, are considering a new healthcare regimen, or think you may be suffering from any medical condition you should seek immediate attention from your own healthcare professional or emergency department.